母乳喂养的差异及其在黑白裔母亲城市出生队列中的中介因素。
Breastfeeding Disparities and Their Mediators in an Urban Birth Cohort of Black and White Mothers.
机构信息
Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Division of Infectious Diseases, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
出版信息
Breastfeed Med. 2021 Jun;16(6):452-462. doi: 10.1089/bfm.2020.0327. Epub 2021 Mar 17.
Black mothers in the United States have shorter breastfeeding (BF) durations and less exclusive breastfeeding (EBF) than others. The factors underlying these disparities require investigation. Using longitudinal data from a CDC-sponsored birth cohort in Cincinnati, Ohio, we analyzed the factors mediating racial disparity in BF outcomes. Study mothers were enrolled in prenatal clinics associated with two large birth hospitals. Analysis was restricted to racial groups with sufficient numbers in the cohort, non-Hispanic Black ( = 92) and White ( = 113) mothers, followed to at least 6 months postpartum. Black mothers were 25 times more likely to reside in socioeconomically deprived neighborhoods and 20 times more likely to have an annual household income <$50,000/year than White mothers ( < 0.001). The gap in EBF for 6 weeks was 45 percentage points by racial group (13%-Black mothers versus 58%-White mothers, < 0.001); in any BF at 6 months was 37 percentage points (28%-Black mothers versus 65%-White mothers, < 0.001); and in mothers meeting their own intention to BF at least 6 months was 51 percentage points (29%-Black mothers versus 80%-White mothers, < 0.001). Racial disparity in EBF at 6 weeks was mediated in logistic regression models by inequities in socioeconomic position, maternal hypertension, and BF intention. Racial disparities in BF at 6 months or meeting 6-month BF intention were mediated by inequities in socioeconomic position, maternal obesity, and EBF at 6 weeks. Not all BF disparities could be explained by models used in these analyses. Efforts to lessen BF disparities should address the underlying structural inequities that disproportionately affect Black mothers and children, should incorporate maternal health, and focus on breastfeeding exclusivity and duration. Few Black mothers achieved EBF at 6 weeks, which contributed to disparity in BF duration. Greater attention to Black mother-infant pairs is a public health priority.
美国的黑人母亲母乳喂养（BF）持续时间较短，纯母乳喂养（EBF）比例也较低。造成这些差异的原因需要进一步研究。本研究使用了美国疾病控制与预防中心（CDC）在俄亥俄州辛辛那提赞助的一项出生队列纵向数据，分析了 BF 结果中种族差异的中介因素。研究母亲在与两家大型分娩医院相关的产前诊所注册。分析仅限于队列中数量足够的种族群体，即非西班牙裔黑人（ = 92）和白人（ = 113）母亲，随访至产后至少 6 个月。黑人母亲居住在社会经济贫困社区的可能性是白人母亲的 25 倍，家庭年收入低于 50,000 美元/年的可能性是白人母亲的 20 倍（ < 0.001）。6 周时 EBF 的种族差异为 45 个百分点（黑人母亲为 13%，白人母亲为 58%， < 0.001）；6 个月时任何 BF 的种族差异为 37 个百分点（黑人母亲为 28%，白人母亲为 65%， < 0.001）；达到至少 6 个月 BF 目标的母亲比例差异为 51 个百分点（黑人母亲为 29%，白人母亲为 80%， < 0.001）。在逻辑回归模型中，6 周时 EBF 的种族差异通过社会经济地位、产妇高血压和 BF 意愿的不平等来调节。6 个月时 BF 或达到 6 个月 BF 目标的种族差异由社会经济地位、产妇肥胖和 6 周时 EBF 的不平等来调节。并非所有 BF 差异都可以用这些分析中使用的模型来解释。减轻 BF 差异的努力应该解决那些不成比例地影响黑人母亲和儿童的结构性不平等问题，应纳入产妇健康，并关注母乳喂养的排他性和持续时间。很少有黑人母亲在 6 周时达到 EBF，这导致 BF 持续时间的差异。更加关注黑人母婴对是公共卫生的优先事项。
Zotero 插件